Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • NEWS AND VIEWS

An umbrella approach to test lung cancer therapies

A clinical trial has tested the use of gene-sequencing results for lung cancer to match patients to targeted therapies. Some paired treatments were a good fit, but others did not succeed, for reasons that will require further exploration.
  1. Alexander Drilon

    1. Alexander Drilon is in the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA, and in the Department of Medicine, Weill Cornell Medical College, New York.

    View author publications

    You can also search for this author in PubMed  Google Scholar

  2. Matthew D. Hellmann

    1. Matthew D. Hellmann is in the Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA, and in the Department of Medicine, Weill Cornell Medical College, New York.

    View author publications

    You can also search for this author in PubMed  Google Scholar

Genomic complexity is a hallmark of many cancers. Within this complexity, the identification of specific DNA alterations for which targeted therapeutic options are available has opened the door to a new era of genome-driven cancer treatment. Approved targeted therapies are in clinical use for a long list of cancer-related genomic alterations, on the basis of evidence that matched treatments lead to improvements in survival times and response (a decrease in tumour size). However, there is an ongoing need to find therapeutic matches for other, unvetted, genomic changes associated with cancer. Writing in Nature, Middleton et al.1 report a clinical trial undertaken using a framework termed an umbrella trial2 to search for such treatment pairings. In this sort of trial, under the ‘umbrella’ of a single type of cancer investigated — lung cancer, in this case — the effectiveness of different targeted therapies is investigated in ‘arms’ of the trial, each corresponding to a tumour subset that harbours specific genomic alterations of interest.

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

Nature 583, 688-689 (2020)

doi: https://doi.org/10.1038/d41586-020-02062-5

References

  1. Middleton, G. et al. Nature 583, 807–812 (2020).

    Article  Google Scholar 

  2. Woodcock, J. & LaVange, L. M. N. Engl. J. Med. 377, 62–70 (2017).

    Article  PubMed  Google Scholar 

  3. Mok, T. S. et al. N. Engl. J. Med. 376, 629–640 (2017).

    Article  PubMed  Google Scholar 

  4. Shaw, A. T. et al. N. Engl. J. Med. 371, 1963–1971 (2014).

    Article  PubMed  Google Scholar 

  5. Drilon, A. et al. Nature Med. 26, 47–51 (2020).

    Article  PubMed  Google Scholar 

  6. Hyman, D. M. et al. N. Engl. J. Med. 373, 726–736 (2015).

    Article  PubMed  Google Scholar 

  7. Govindan, R. et al. J. Thorac. Oncol. 14, S208 (2019).

    Article  Google Scholar 

Download references

Competing Interests

A.D. has received honoraria or been on the advisory boards of Ignyta, Genentech, Roche, Loxo, Bayer, Lilly Takeda, Ariad, Millenium, TP Therapeutics, AstraZeneca, Pfizer, Blueprint Medicines, Helsinn, Beigene, BergenBio, Hengrui Therapeutics, Exelixis, Tyra Biosciences, Verastem, MORE Health Abbvie, 14ner, Elevation Oncology, Remedica, ArcherDX and Monopteros. A.D. has received payment to his institution for associated research from Pfizer, Exelixis, GlaxoSmithKline, Teva, Taiho, PharmaMar. A.D. has received payment for research from Foundation Medicine, has received royalties from Wolters Kluwer and has received payment for food/beverages from Merck and Puma and other payments from Merus and Boehringer Ingelheim. A.D. has received honoraria for continuing medical education from Medscape, OncLive, PeerVoice, Physicians Education Resources, Targeted Oncology, Research to Practice, Axis, Peerview Institute, Paradigm Medical Communications and WebMD. M.D.H. receives institutional research funding from Bristol Myers Squibb; has been a compensated consultant for Merck, Bristol Myers Squibb, AstraZeneca, Genentech/Roche, Nektar, Syndax, Mirati, Shattuck Labs, Immunai, Blueprint Medicines, Achilles and Arcus; received travel support/honoraria from AstraZeneca, Eli Lilly and Bristol Myers Squibb; has options from Shattuck Labs, Immunai and Arcus; and has a patent filed by his institution related to the use of tumour mutation burden to predict response to immunotherapy (PCT/US2015/062208), which has received licensing fees from PGDx.

Subjects

Latest on:

Nature Careers

Jobs

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing

Search

Advanced search

Quick links